Fix baggy, heavy looking eyes

Dear Doctor: I have very heavy looking eyes. Really, my eyes are the only thing that bothers me about the aging process so far. Is there a procedure where you can get your eyes done without having a facelift?

Dear Reader: Yes. This procedure is called blepharoplasty. You see, humans have four eyelids- two upper lids and two lower lids. The upper and lower eyelids may contain wrinkles, loose skin, and bulges due either to hereditary factors or the aging process. Pouches or bags of the upper and lower lids are generally due to herniations of the fat normally localized within the eye socket. These fatty hernias may be removed in the lid plastic procedure. Fatty pouches are often seen in the 20-30 year age group, sometimes younger, and can often be corrected at that time. There is little rationale to wait for some arbitrary age before having surgery. When the problem exists, it should be corrected.

Upper lid surgery is usually done at the same time as the lower lid surgery but either can be done as an isolated procedure. Upper and lower eyelid plastic surgery may be done with or without a facelift, brow lift or other surgery.

In upper lid blepharoplasty a determination is made about the excess or overlapping skin which frequently obscures the natural crease above the lashes. After the area has been anesthetized the excess skin and fat are removed and the incision sites are closed - under magnification - with delicate sutures.

In some patients the herniated fat producing "bags" or bulges in the lower lid can be removed without making an incision in the skin. The incision is made behind the lower lid thereby eliminating a visible scar.

It is not possible to remove loose skin or sagging wrinkles with the behind the lid approach; however skin resurfacing (laser, peeling or dermabrasion) to remove fine wrinkles can be performed at the same time.

The classical lower lid procedure is be performed by making an incision in the skin below the lower lashes at a level determined by the surgeon and elevating the skin so that the fatty pouches or "hernias" can be identified. Once fat is removed the excess skin is trimmed. Small delicate absorbable sutures are used to close the lower lid incisions. When loose skin needs to be removed it is necessary to make the incision on the outside of the lid.

With the passage of time, the incision lines of the upper and lower lids are usually camouflaged.

As a rule, eyelid procedures are associated with minor disability and allow one to return to routine living after a few days using cosmetics and sunglasses.

Most patients tell us that there is little or no pain in the postoperative period. Each operation is followed by varying degrees of swelling and/or discoloration, most of which usually subsides within 7-10 days. By this time, too, the scars can be camouflaged by makeup; these scars gradually blend in with the surrounding skin. After several months have passed, in most cases, scars become perceptible only upon close scrutiny.

Anyone can request a free copy of Dr. McCollough's latest book, by calling the McCollough Institute for Appearance and Health at 850- 967-7000 or by visiting www.mccolloughinstitute.com.